scholarly journals We have the program, what now? Development of an implementation plan to bridge the research-practice gap prevalent in exercise oncology

2020 ◽  
Vol 17 (1) ◽  
Author(s):  
Mary A. Kennedy ◽  
Sara Bayes ◽  
Robert U. Newton ◽  
Yvonne Zissiadis ◽  
Nigel A. Spry ◽  
...  
Keyword(s):  
Theoretical Domains Framework ◽  
Implementation Strategies ◽  
Treatment Center ◽  
Advisory Group ◽  
Implementation Barriers ◽  
Implementation Plan ◽  
Oncology Research ◽  
The Individual ◽  
Specific Implementation ◽  
Exercise Oncology

Abstract Background Exercise has emerged as a promising therapy for people with cancer. Novel programs have been developed to translate research into practice; however, implementation barriers have limited their success in part because successful translation of exercise oncology research into practice requires context-specific implementation plans. The aim of this study was to employ the implementation mapping protocol to develop an implementation plan to support programming of a co-located exercise clinic and cancer treatment center. Methods The Implementation Mapping protocol, which consists of five specific iterative tasks, was used. A stakeholder advisory group advised throughout the process. Results A comprehensive needs assessment was used to identify the organization’s general manager as the program adopter; oncologists, center leaders, and various administrative staff as program implementers; and the operations manager as the program maintainer. Twenty performance objectives were identified. The theoretical domains framework was used to identify likely determinants of change, which informed the selection of eight individual implementation strategies across the individual and organizational levels. Finally, an evaluation plan was developed which will be used to measure the success of the implementation plan in the project’s next phase. Conclusion The Implementation Mapping protocol provided a roadmap to guide development of a comprehensive implementation plan that considered all ecological domains, was informed by theory, and demonstrated an extensive understanding of the implementation context. Strong research-practitioner partnerships and effective stakeholder engagement were critical to development of the plan.

scholarly journals We have the program, what now? Development of an implementation plan to bridge the research-practice gap prevalent in exercise oncology

2020 ◽  
Author(s):  
Mary Ann Kennedy ◽  
Sara Bayes ◽  
Robert U. Newton ◽  
Yvonne Zissiadis ◽  
Nigel A. Spry ◽  
...  
Keyword(s):  
Theoretical Domains Framework ◽  
Implementation Strategies ◽  
Treatment Center ◽  
Advisory Group ◽  
Implementation Barriers ◽  
Implementation Plan ◽  
Oncology Research ◽  
The Individual ◽  
Specific Implementation ◽  
Exercise Oncology

Abstract Background Exercise has emerged as a promising therapy for people with cancer. Novel programs have been developed to translate research into practice; however, implementation barriers have limited their success in part because successful translation of exercise oncology research into practice requires context-specific implementation plans. The aim of this study was to employ the implementation mapping protocol to develop an implementation plan to support programming of a co-located exercise clinic and cancer treatment center.Methods The Implementation Mapping protocol, which consists of five specific iterative tasks, was used. A stakeholder advisory group advised throughout the process.Results A comprehensive needs assessment was used to identify the organization’s general manager as the program adopter; oncologists, center leaders, and various administrative staff as program implementers; and the operations manager as the program maintainer. Twenty performance objectives were identified. The theoretical domains framework was used to identify likely determinants of change, which informed the selection of eight individual implementation strategies across the individual and organizational levels. Finally, an evaluation plan was developed which will be used to measure the success of the implementation plan in the project’s next phase. Conclusion The Implementation Mapping protocol provided a roadmap to guide development of a comprehensive implementation plan that considered all ecological domains, was informed by theory, and demonstrated an extensive understanding of the implementation context. Strong research-practitioner partnerships and effective stakeholder engagement were critical to development of the plan.

scholarly journals We have the program, what now? Development of an implementation strategy to bridge the research-practice gap prevalent in exercise oncology

2020 ◽  
Author(s):  
Mary Ann Kennedy ◽  
Sara Bayes ◽  
Robert U. Newton ◽  
Yvonne Zissiadis ◽  
Nigel A. Spry ◽  
...  
Keyword(s):  
Implementation Strategy ◽  
Implementation Strategies ◽  
Study Data ◽  
Treatment Center ◽  
Advisory Group ◽  
Science Literature ◽  
Implementation Barriers ◽  
Oncology Research ◽  
Specific Implementation ◽  
Exercise Oncology

Abstract Background Exercise has emerged as a promising therapy for people with cancer. Novel programs have been developed to translate this research into practice; however, implementation barriers have limited their success. The aim of this study was to employ the implementation mapping protocol to develop an implementation strategy to effectively support programming of a co-located exercise clinic and cancer treatment center. Methods The Implementation Mapping protocol, which consists of five specific, iterative tasks, was employed for this study. Data from interviews, surveys, clinic records, and implementation science literature was used to develop a comprehensive implementation strategy for the co-located exercise clinic. A stakeholder advisory group advised throughout the process. Results The organization’s general manager was identified as the program adopter; oncologists, center leaders, and various administrative staff as program implementers; and the operations manager as the program maintainer. Twenty performance objectives were identified and used to inform the development of a comprehensive theory-based implementation plan consisting of seven implementation strategies across the individual and organizational levels, including use of program champions and an implementation advisor, and revision of professional roles. Finally, an evaluation plan was developed to measure the success of the implementation strategy. Conclusion Successful translation of exercise oncology research into practice requires context-specific implementation plans. The Implementation Mapping protocol provided a roadmap to guide development of a robust implementation strategy that considered all ecological domains, was informed by theory, and demonstrated an extensive understanding of the implementation context. Strong research-practitioner partnerships and effective stakeholder engagement were critical to successful execution of the protocol.

A Toolkit for Implementation of Clinical Genomic Testing: Using a Combined Stakeholder and Evidence-Driven Approach

2021 ◽  
Author(s):  
Natalie Taylor ◽  
Janet C Long ◽  
Clara Gaff ◽  
Kathryn North ◽  
Jeffrey Braithwaite ◽  
...  
Keyword(s):  
Scale Up ◽  
Health Benefit ◽  
Intervention Development ◽  
Theoretical Domains Framework ◽  
Implementation Strategies ◽  
Practice Change ◽  
Genomic Testing ◽  
Behaviour Change Techniques ◽  
Target Behaviour ◽  
Specific Implementation

Abstract BACKGROUNDThe complexity of clinical genomics – testing your entire genetic information for health benefit – is a rapidly evolving field demanding swift clinical practice change at multiple levels as widespread testing in healthcare becomes a reality. We aimed to a) describe a combined stakeholder- and evidence-driven approach to developing a toolkit for implementing genomics into the Australian health system, and b) hypothesise key steps in the change to Theoretical Domains Framework (TDF) domains via coded implementation strategies and associated mechanistic links. METHODSThe TDF was used to analyse interview data from 16 nongenetic medical specialists using genomics in practice. Barriers and enablers were identified for three key target behaviour areas across the genomic testing process: 1) identifying patients, 2) test ordering/reporting, and 3) providing results. Barriers were grouped by distinct TDF domains, and, where barriers overlapped, ‘overarching’ domains were identified. Intuitive enabling strategies generated by clinicians were aligned with identified barriers, and retrospectively coded against evidence-based behaviour change techniques (BCTs). Additional theory-driven strategies were developed to address remaining identified barriers. Using structured expert consensus processes, members of the research team participated in a series of workshops to discuss and agree theory-informed links and propose mechanisms through which specific implementation strategies would address TDF-based barriers.RESULTSA total of 32 barriers were coded against TDF domains and constructs, and eight overarching TDF domains were identified on 13 occasions. Across all target behaviour areas, 21 BCTs were represented within the 30 intuitive enabling strategies generated by clinicians, found to be used on 49 occasions. Of these, nine (18%) aligned with a corresponding distinct TDF domain coded barrier that has previously demonstrated statistically significant mechanistic links. 20 new implementation strategies were developed to address nine remaining barriers using a theory-driven approach.CONCLUSIONThis study provides rich detail of crucial stages in intervention development, aiming to ensure implementation strategies are both evidence-informed and contextually appropriate. All barriers were mapped to the TDF, implementation strategies coded against BCTs, and standardised hypothesised behavioural pathways have been proposed, making potential underlying theory explicit. Next steps will be to test toolkit effectiveness for facilitating scale-up of genomics across Australia.

scholarly journals Data-driven approach for tailoring facilitation strategies to overcome implementation barriers in community pharmacy

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Lydia Moussa ◽  
Shalom Benrimoj ◽  
Katarzyna Musial ◽  
Simon Kocbek ◽  
Victoria Garcia-Cardenas
Keyword(s):  
Random Forest ◽  
Community Pharmacy ◽  
Implementation Research ◽  
Theoretical Domains Framework ◽  
Professional Services ◽  
Data Driven ◽  
Machine Learning Techniques ◽  
Community Pharmacies ◽  
Continuous Change ◽  
Implementation Barriers

Abstract Background Implementation research has delved into barriers to implementing change and interventions for the implementation of innovation in practice. There remains a gap, however, that fails to connect implementation barriers to the most effective implementation strategies and provide a more tailored approach during implementation. This study aimed to explore barriers for the implementation of professional services in community pharmacies and to predict the effectiveness of facilitation strategies to overcome implementation barriers using machine learning techniques. Methods Six change facilitators facilitated a 2-year change programme aimed at implementing professional services across community pharmacies in Australia. A mixed methods approach was used where barriers were identified by change facilitators during the implementation study. Change facilitators trialled and recorded tailored facilitation strategies delivered to overcome identified barriers. Barriers were coded according to implementation factors derived from the Consolidated Framework for Implementation Research and the Theoretical Domains Framework. Tailored facilitation strategies were coded into 16 facilitation categories. To predict the effectiveness of these strategies, data mining with random forest was used to provide the highest level of accuracy. A predictive resolution percentage was established for each implementation strategy in relation to the barriers that were resolved by that particular strategy. Results During the 2-year programme, 1131 barriers and facilitation strategies were recorded by change facilitators. The most frequently identified barriers were a ‘lack of ability to plan for change’, ‘lack of internal supporters for the change’, ‘lack of knowledge and experience’, ‘lack of monitoring and feedback’, ‘lack of individual alignment with the change’, ‘undefined change objectives’, ‘lack of objective feedback’ and ‘lack of time’. The random forest algorithm used was able to provide 96.9% prediction accuracy. The strategy category with the highest predicted resolution rate across the most number of implementation barriers was ‘to empower stakeholders to develop objectives and solve problems’. Conclusions Results from this study have provided a better understanding of implementation barriers in community pharmacy and how data-driven approaches can be used to predict the effectiveness of facilitation strategies to overcome implementation barriers. Tailored facilitation strategies such as these can increase the rate of real-time implementation of innovations in healthcare, leading to an industry that can confidently and efficiently adapt to continuous change.

scholarly journals Provider Perspectives on Telepractice for Serving Families of Children who are Deaf or Hard of Hearing

2015 ◽  
Vol 7 (1) ◽  
pp. 3-12 ◽  
Author(s):  
Diane D. Behl ◽  
Gary Kahn
Keyword(s):  
Learning Community ◽  
Hard Of Hearing ◽  
Implementation Strategies ◽  
Provider Perspectives ◽  
Disabilities Education Act ◽  
Education Act ◽  
Specific Implementation ◽  
Part C Early Intervention ◽  
Growing Strategy ◽  
Remote Part

Telepractice to deliver remote Part C early intervention (EI) services to families in their home is a rapidly-growing strategy under the Individuals with Disabilities Education Act (IDEA) to meet the needs of infants and toddlers who are deaf or hard of hearing. A survey was completed within a “learning community” comprised of staff from EI programs that were implementing telepractice to learn about their specific implementation strategies and challenges they faced. Twenty-seven individuals representing 11 programs responded. The results showed great variability in hardware and software, with many raising concerns regarding security. Primary challenges reported were internet connectivity and training in skills required to deliver telepractice services. The findings from this survey were valuable in guiding future areas of investigation for the learning community and ultimately improving telepractice in the field. 

Providing Effective Transitional Programming to Individuals with Autism

1995 ◽  
Vol 21 (1) ◽  
pp. 36-52 ◽  
Author(s):  
Stephen C. Luce ◽  
Kathleen Dyer
Keyword(s):  
Developmental Disabilities ◽  
Implementation Strategies ◽  
Treatment Center ◽  
Comprehensive Treatment ◽  
Transition Programming ◽  
Organizational Perspective ◽  
Professional Perspective ◽  
Legal Mandates ◽  
Wide Scale ◽  
Natural Settings

Legal mandates, widely postulated professional perspective, and improved teaching techniques have strongly influenced the kind of care provided individuals with significant developmental disabilities such as autism. Children and adults who would have been separated from their families and peers two decades ago are now expected to live in natural settings identical to the settings in which other members of their families live. The conversion of services to correspond with the ever increasing lifestyle expectations for persons with developmental disabilities is described from an organizational perspective with reference to serving these individuals in special education classrooms, residential settings, or other human service settings. Systems we have found effective in moving individuals through a continuum of services are described. Specific examples of implementation strategies in a large comprehensive treatment center for individuals with developmental and neurological disabilities are provided. An example of a wide-scale conversion of an agency that resulted in more progressive transition programming is discussed.

scholarly journals Exploring Equity and Inclusion in Malawi’s National Disability Mainstreaming Strategy and Implementation Plan

2020 ◽  
Author(s):  
Ikenna D Ebuenyi ◽  
Emma M. Smith ◽  
Alister Munthali ◽  
Steven W. Msowoya ◽  
Juba Kafumba ◽  
...  
Keyword(s):  
Policy Development ◽  
Development Process ◽  
Implementation Strategies ◽  
Strategy Development ◽  
Implementation Plan ◽  
Analytical Methodology ◽  
Persons With Disabilities ◽  
Policy Development Process ◽  
Inclusive Processes ◽  
Equity And Inclusion

Abstract Background: Equity and inclusion are important principles in policy development and implementation. The aim of this study is to explore the extent to which equity and inclusion were considered in the development of Malawi’s National Disability Mainstreaming Strategy and Implementation Plan. Methods: We applied an analytical methodology to review the Malawi’s National Disability Mainstreaming Strategy and Implementation Plan using the EquIPP (Equity and Inclusion in Policy Processes) tool. The EquIPP tool assesses 17 Key Actions to explore the extent of equity and inclusion. Results: The development of the Malawi National Disability Mainstreaming Strategy and Implementation Plan was informed by a desire to promote the rights, opportunities and wellbeing of persons with disability in Malawi. The majority (58%) of the Key Actions received a rating of three, indicating evidence of clear, but incomplete or only partial engagement of persons with disabilities in the policy process. Three (18%) of the Key Actions received a rating of four indicating that all reasonable steps to engage in the policy development process were observed. Four (23%) of the Key Actions received a score five indicating a reference to Key Action in the core documents in the policy development process. Conclusion: The development of disability policies and associated implementation strategies requires equitable and inclusive processes that consider input from all stakeholders especially those whose wellbeing depend on such policies. It is pivotal for government and organisations in the process of policy or strategy development and implementation, to involve stakeholders in a virtuous process of co-production – co-implementation – co-evaluation, which may strengthen both the sense of inclusion and the effectiveness of the policy life-cycle.

scholarly journals Evaluating the implementation of a primary care intervention to reduce prescriptions of benzodiazepines (BENZORED IV)

2021 ◽  
Author(s):  
Isabel Socias ◽  
Alfonso Leiva ◽  
Haizea Pombo-Ramos ◽  
Ferran Bejarano ◽  
Ermengol Sempere-Verdú ◽  
...  
Keyword(s):  
Primary Care ◽  
Traffic Accidents ◽  
Implementation Strategies ◽  
Developed Countries ◽  
Successful Implementation ◽  
Implementation Climate ◽  
Primary Care Settings ◽  
The Individual

Abstract Background: General practitioners (GPs) in developed countries widely prescribe benzodiazepines (BZDs) for their anxiolytic, hypnotic, and muscle-relaxant effects. Treatment duration, however, is rarely limited and this results in a significant number of chronic users. Long-term BZD use is associated with cognitive impairment, falls with hip fractures, traffic accidents, and increased mortality. The BENZORED IV trial was a hybrid type 1 trial conducted to evaluate the effectiveness and implementation of an intervention to reduce BZD prescription in primary care. The purpose of this qualitative study was to analyze facilitator and barriers to implement the intervention to primary care settings.Methods: Focus group meetings with GPs from the intervention arm of the BENZORED IV trial were held at primary healthcare centers in the three districts. For sampling purposes, the GPs were classified as high or low implementers according to the success of the intervention measured at 12 months. The Consolidated Framework for Implementation Research (CFIR) was used to conduct the meetings and to code, rate and analyze the dataResults: Three of the 41 CFIR constructs strongly distinguished between high and low implementers: The complexity in the intervention, the individual Stage of Change and the key stakeholder’s engagement. Seven constructs weakly discriminated between the two groups: the adaptability in the intervention, the external policy and incentives, the implementation climate, the relative priority, the self-efficacy and formally appointed implementation leader engaging. Fourteen constructs did not discriminate between the two groups, six had insufficient data for evaluation, and eleven had no data for evaluation.Conclusion: We identified constructs that could explain the variation in the implementation of the intervention, this information is relevant to design successful implementation strategies to implement the intervention.

Improving the quality of self-management support in ambulatory cancer care: a mixed-method study of organisational and clinician readiness, barriers and enablers for tailoring of implementation strategies to multisites

2021 ◽  
pp. bmjqs-2020-012051
Author(s):  
Doris Howell ◽  
Melanie Powis ◽  
Ryan Kirkby ◽  
Heidi Amernic ◽  
Lesley Moody ◽  
...  
Keyword(s):  
Mixed Method ◽  
Cancer Care ◽  
Implementation Strategies ◽  
Self Management ◽  
Normalisation Process Theory ◽  
Mixed Method Study ◽  
Successful Implementation ◽  
Management Support ◽  
Specific Implementation

IntroductionImproving the quality of self-management support (SMS) for treatment-related toxicities is a priority in cancer care. Successful implementation of SMS programmes depends on tailoring implementation strategies to organisational readiness factors and barriers/enablers, however, a systematic process for this is lacking. In this formative phase of our implementation-effectiveness trial, Self-Management and Activation to Reduce Treatment-Related Toxicities, we evaluated readiness based on constructs in the Consolidated Framework for Implementation Research (CFIR) and Normalisation Process Theory (NPT) and developed a process for mapping implementation strategies to local contexts.MethodsIn this convergent mixed-method study, surveys and interviews were used to assess readiness and barriers/enablers for SMS among stakeholders in 3 disease site groups at 3 regional cancer centres (RCCs) in Ontario, Canada. Median survey responses were classified as a barrier, enabler or neutral based on a priori cut-off values. Barriers/enablers at each centre were mapped to CFIR and then inputted into the CFIR-Expert Recommendations for Implementing Change Strategy Matching Tool V.1.0 (CFIR-ERIC) to identify centre-specific implementation strategies. Qualitative data were separately analysed and themes mapped to CFIR constructs to provide a deeper understanding of barriers/enablers.ResultsSMS in most of the RCCs was not systematically delivered, yet most stakeholders (n=78; respondent rate=50%) valued SMS. For centre 1, 7 barriers/12 enablers were identified, 14 barriers/9 enablers for centre 2 and 11 barriers/5 enablers for centre 3. Of the total 46 strategies identified, 30 (65%) were common across centres as core implementation strategies and 5 tailored implementation recommendations were identified for centres 1 and 3, and 4 for centre 2.ConclusionsThe CFIR and CFIR-ERIC were valuable tools for tailoring SMS implementation to readiness and barriers/enablers, whereas NPT helped to clarify the clinical work of implementation. Our approach to tailoring of implementation strategies may have relevance for other studies.

Barriers for Lean implementation in the textile industry

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Galina Robertsone ◽  
Iveta Mezinska ◽  
Inga Lapina
Keyword(s):  
Textile Industry ◽  
Success Factors ◽  
Manufacturing Sector ◽  
Qualitative Content Analysis ◽  
Original Research ◽  
Implementation Barriers ◽  
Lean Implementation ◽  
Content Type ◽  
Non Profit ◽  
Specific Implementation

Purpose The fundamentals of Lean are applicable and can be used in any industry, even non-profit and government organizations, however, there might be certain limitations due to the nature and the specifics of the industry. This study aims to explore what barriers of Lean implementation textile manufacturers might encounter. The authors consider the problem is worth to be explored for the potential to improve the effectiveness of Lean implementation in textile sector companies. Design/methodology/approach This research was conducted by using qualitative content analysis with open coding of the selected literature followed by empirical research in a Latvian textile manufacturing company. Findings The presented literature review shows Lean implementation barriers and critical success factors in various industries. The findings from the case study can be divided into two groups. The first confirmed the barriers already identified in the previous research. The second identified industry specific implementation barriers that were not recognized in the related literature. Research limitations/implications The original research was limited in scope to one Latvian textile manufacturer, therefore future studies on the subject to confirm the outcome of the research are required. Originality/value There is a limited number of studies on the application of Lean in the textile and apparel industry. The literature on Lean implementation in the Latvian manufacturing sector is also limited. The results of this research may have a practical application for textile manufactures considering implementing Lean in their processes.

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